Key Points Question Can a 6-month online group-coaching program targeted for various learning styles reduce burnout, moral injury, and impostor syndrome and increase self-compassion among female resident physicians? Findings In this pilot randomized clinical trial of 101 female resident physicians, participants who were randomly assigned to a 6-month group-coaching program and a follow-up survey had a statistically significant reduction in the emotional exhaustion subscale of burnout compared with the control group. Meaning An online multiformat group-coaching program may be an effective intervention to decrease burnout and improve well-being for female resident physicians.

Background The Veterans Health Administration (VHA) Opioid Safety Initiative (OSI) was implemented in 2013 and was associated with a 25% relative decrease in the dispensing of opioids. Although emergency department (ED) providers play a role in the initiation and continuation of opioids, the incumbent OSI did not target EDs. Objective The goal of this feasibility study was to leverage the existing VHA OSI and test a novel ED‐based quality improvement (QI) program to decrease opioid prescribing in multiple ED settings. Methods This was a quasi‐experimental study of phased‐in implementation of a QI ED‐based OSI. The general setting for this pilot were four VHA EDs across the Veterans Integrated Services Network (VISN) region 19: Denver, Oklahoma City, Muskogee, and Salt Lake City. We developed and disseminated a dashboard to assess ED‐specific prescribing rates and an ED‐tailored toolkit to implement the program. Academic detailing pharmacists provided focused audits and feedback with the highest prescribing providers. We measured change in ED‐provider prescribing rate of opioids for patients discharged from the ED, by provider and aggregated up to facility level, pre‐ and postimplementation. Results Interrupted time‐series analysis of provider‐level data from the program implementation sites indicated a significant decrease in the trend for proportion of opioid prescriptions relative to the preintervention trend. The results of the analysis suggest that the intervention was associated with accelerating the rate at which ED provider prescribing rates decreased. Conclusion Due to the high volume of patients and the vital role the ED plays in patient treatment and hospital admissions, it is evident that the ED is an important site for QI programs as well as the implementation of opioid safety measures. Given the findings of this pilot, we believe that implementation of a national Veterans Affairs ED OSI implementation is feasible practice.

Background Trainees in graduate medical education are affected by burnout at disproportionate rates. Trainees experience tremendous growth in clinical skills and reasoning, however little time is dedicated to metacognition to process their experiences or deliberate identity formation to create individualized definitions of success and wellbeing. The purpose of this study was to understand the perspectives and experiences of trainees who participated in a 6-month, web-based, group coaching program for women residents in training. Methods Better Together Physician Coaching is a six-month, self-paced, online, asynchronous, coaching program with multiple components including live coaching calls, unlimited written coaching, and self-study modules. Semi-structured interviews of seventeen participants of Better Together from twelve GME programs within a single institution in Colorado were conducted from May to June of 2021. All identified as women and had participated in a 6-month coaching program. Both inductive and deductive methods were used in collecting and analyzing the data with an aim to understand learners’ perceptions of the coaching program, including “how and why” the coaching program affected training experiences and wellbeing. Results Three main themes emerged as benefits to the coaching program from the data: 1) practicing metacognition as a tool for healthy coping 2) building a sense of community, and 3) the value of a customizable experience. Conclusions Female trainees who participated in a group coaching program expressed that they found value in learning how to cope with stressors through metacognition-focused coaching. They also described that building a community and being able to customize the experience were positive aspects of the program. Trial registration ClinicalTrials.gov Identifier: NCT05280964. Date of registration: March 15th 2022. Retrospectively registered. URL of trial registry record.

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